Neighbourhood Disadvantage and Vision Screening Failure Rates: Analysis of a School-Based Vision Program in Baltimore, Maryland

ABSTRACT

Purpose

To investigate the relationship between neighbourhood disadvantage and vision screening failure rates.

Methods

This analysis uses aggregate data from pre-kindergarten to eighth grade schools participating in a school-based vision programme in Baltimore, Maryland, from 2016 to 2019. Data on number of students screened and number of students who failed vision screening per grade level were recorded for each school. The Area Deprivation Index (ADI) was obtained for each school using the school’s ZIP+4 code. The association between vision screening failure rates by grade and school ADI was analysed using negative binomial regression models, adjusted for grade level and accounting for clustering by school.

Results

Nine hundred seventy-two grades across 117 schools were included in this analysis. Median national ADI percentile across the sample was 71 [interquartile range (IQR): 48–85] (100 = most deprived). The median grade-level screening failure rate across the entire sample was 33% [IQR: 26–41%]. School ADI was not associated with vision screening failure rate (incidence rate ratio (IRR) = 1.01 per 10 percentage point increase in ADI, 95% CI: 0.99, 1.03, p = 0.217).

Conclusions

In this study, there was no association between vision screening failure rates and school ADI. With one in three students failing screening in a high poverty public school district, these findings suggest a high need for vision services across schools in all neighbourhoods. Future work should investigate the impact of students’ home ADI and socioeconomic status on vision screening outcomes.

KEYWORDS:

• Neighbourhood disadvantage
• paediatric vision screening
• school-based vision care

Acknowledgments

We gratefully acknowledge the contributions of the following individuals from the Vision for Baltimore programme: Baltimore City Health Department: Letitia Dzirasa, Mary Beth Haller, Francine Childs, Joy Twesigye, and Tempestt Little; Baltimore City Public Schools: Sonya Santelises and Louise Fink; Vision To Learn: Ann Hollister, Damian Carroll, and Wade Brown; Warby Parker: Hannah Reeve and Jesse Schultz Sneath; Johns Hopkins University: Christine SySantos Levy, Grace Galiani, and Anne Currie.

Disclosure statement

A product used in the study described in this publication was manufactured by Warby Parker. Dr Collins was a paid consultant to Warby Parker at the time study was conducted. Dr Collins is also a Member of the Board of Directors at Warby Parker Impact Foundation. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict-of-interest policies. None of the following authors have any proprietary interests or conflicts of interest related to this submission: Hursuong Vongsachang, Xinxing Guo, David S. Friedman, and Gayane Yenokyan.

Statement

This submission has not been published anywhere previously and is not simultaneously being considered for any other publication.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09286586.2022.2119259

Additional information

Funding

This work was supported by the National Center for Advancing Translational Sciences [TL1 TR003100].